Family practitioners' perceptions of, knowledge about and use of peak flow meters in the Lenasia, Lenasia South and Soweto Community Health Clinics

Abstract

Background: The purpose of this paper was to determine the availability of peak flow meters, perceptions about their usefulness and the perceptions of clinical indications for their use. Methods: A questionnaire was administered to private and public sector practitioners (n=72) working in three urban areas of greater Johannesburg. Data were collected concerning practice profiles, the characteristics of the practitioners, the extent of and indications for use, and the reasons for failure to use these meters. Results: The results showed that only 21 (29%) of the practitioners advised their asthma patients to use peak flow meters for home monitoring. A scoring system (summary score), which was developed to summarise knowledge of both the indications for the use of the meters and the method of peak flow measurement, showed that only 33.3% of the practitioners attained maximum or close to maximum scores (6 to 8 of an 8-point scale). Conclusion: Peak flow meters were underutilised by family practitioners. The cost of the peak flow meter was an important reported cause of underutilisation, It is recommended that the importance of the peak flow meter in the management of asthma be emphasised at the undergraduate and continuing medical education level. The findings of this study could also be used to guide the national campaign coordinators in South Africa in their strategy to improve asthma care among family practitioners. Since asthma may be under-diagnosed in the community, further research is needed to assess the effects of education in assisting people to recognise asthma. Early recognition and diagnosis of asthma, together with appropriate asthma education, may significantly reduce morbidity. The role of illiteracy and cost in limiting the use of peak flow meters warrants investigation, as does the possibility of developing suitable meters for populations with limited formal education. Doctors need to make more conscientious, concerted and informed efforts to monitor their asthma patients and to collaborate, where appropriate, with health educators to optimise the management of asthma. This could include workshops within the community and with fellow healthcare workers (doctors, primary healthcare sisters) on various aspects of asthma care, which will incorporate inhaler techniques and peak flow meter use.